Spanish Melanoma Multidisciplinary Group (GEM): Long-term survivors treated with ipilimumab (IPI) in the expanded access programme (EAP).

2013 ◽  
Vol 31 (15_suppl) ◽  
pp. e20007-e20007
Author(s):  
Cristina Hernando ◽  
Virtudes Soriano ◽  
Jose Pablo Berros ◽  
Ana Maria Arance ◽  
Karmele Mujika ◽  
...  
Keyword(s):  
Response Assessment ◽  
Median Number ◽  
Term Survival ◽  
Primary Tumor Site ◽  
Long Term Survival ◽  
Expanded Access Programme ◽  
Duration Of Response ◽  
Access Programme

e20007 Background: Advances in metastatic melanoma treatment have demonstrated improvement in survival. After 5 year follow-up of clinical trials with IPI, LTS have been reported. Current follow-up of patients treated within IPI EAP in Spain is 2 years. Methods: we performed a retrospective subgroup analysis of 138 treated patients (pts) within the IPI not randomized EAP (48% of the total EAP population). LTS were defined as pts with ≥ 12 months overall survival (OS). Pts were treated with IPI at 3 mg/kg q 3 w x 4. Data was registered using a socio-demographic and therapeutic questionnaire, collecting overall response (RR), survival (OS) and toxicity (T). Results: In our analysis of138 treated pts 39 were LTS (28.2%), 14 pts were alive at 12 months (M), 12 pts between 13-19 m and 7 pts 20-24m, for all this patients the follow up continues. Median age was: 56.5 (30-81). Gender: Male 48.7%. Stage: IVa 25.6%, IVb 17.9%, IVc 56.8%. Primary tumor site: skin 56.4%; accral 12.8%; mucosal 10.3%; ocular 10.3%; rest unknown. Metastases (mts): soft tissue 38.5%, lung 33.3%, visceral 28.2%. Median number of prior treatments: 1 (1-5), 20.5% received more than one chemotherapy (chx) line. 92.3% of total pts population have completed the induction schema (4 IPI doses). Response assessment: CR 15.4%; PR 38.5%; SD 33.3%; P 12.8%. Mean duration of response: 10.6m. Mean survival: 16.6m. 56.4% received thx after IPI, in those pts 41% received chx; 17.9% radiotherapy; 12.9% B-RAF inhibitor. 18 pts (46.2%) presented T: 12.8% Grades (G) 3-4 were reported; 23.1% G2; 7.7% G1. The most frequent T was cutaneous (17.9%). When compared with the overall EAP pts population LTS have less visceral disease, lower median LDH, more objective responses and completion of the four induction ipilimumab doses. Conclusions: Ipilimumabin the Spanish EAP experience in pretreated patients has shown to improve long term survival similar to that seen in studies in patients with advanced melanoma. Further research and analysis are needed to identify the patient population most likely to achieve a long term survival benefit with ipilimumab treatment.

PS02.142: CONVERSION SURGERY: A FEASIBLE GOAL FOR AFTERWARDS IN CARDIA CANCER TREATMENT

2018 ◽  
Vol 31 (Supplement_1) ◽  
pp. 161-161
Author(s):  
Luca Alberti ◽  
Simone Giacopuzzi ◽  
Carlo Alberto De Pasqual ◽  
Jacopo Weindelmayer ◽  
Roberta La Mendola ◽  
...  
Keyword(s):  
Primary Tumor ◽  
R0 Resection ◽  
Intensive Chemotherapy ◽  
Conversion Surgery ◽  
Cardia Cancer ◽  
Term Survival ◽  
Primary Tumor Site ◽  
Long Term Survival

Abstract Background Conversion surgery is a surgical treatment aiming R0 resection after chemotherapy of tumors that were originally regarded as technically or oncologically unresectable or only marginally resectable. Performing surgery in such patients may result in a long-term survival. The current experience concerns stage IV gastric cancer patients with marginally resectable metastasis, while the evidence concerning cardia tumors are poor. We report a case of primary cardia cancer with potentially unresectable metastasis, successfully treated by a multidisplinary approach including chemotherapy and surgery. Methods We report a case about a 65-year-old man affected by EGJ adenocarcinoma (Siewert II) with multiple hepatic metastases and para-aortic adenopathy (cT3N + M1 according to UICC 7th edition). He received intensive chemotherapy with Taxotere, Cisplatin and 5 FU. After therapy, primary tumor and liver lesions had markedly regressed according to CT, using RECIST guidelines. The endoscopy confirmed the reduction in the cardia lesion with negative biopsies. For that reason, the patient was addressed to follow up. Results After 6 years of follow up, endoscopy indicated a local relapse with a pathological diagnosis of adenocarcinoma. CT scan showed a clinical stage was cT3N + M0. The patient was treated with neoadjuvant concurrent chemoradiotherapy. After treatment the exams showed a partial response. The patient was eligible for conversion surgery and we proceeded to laparotomy total gastrectomy with D2 lymphadenectomy. We performed also exeresis of a liver nodule, which resulted fibrous. The surgical procedure was radical (R0). According to histological examination, the postoperative stage was ypT0N0. Treatment-induced response at the primary tumor site, evaluated according to SPR classification and TRG classification, was SPR 1 and TRG 1. Conclusion Despite limited evidence in literature about conversion surgery in cardia carcinoma, this case shows that intensive chemotherapy allows for conversion of unresectable cardia cancer to resectable cancer, resulting in long-term survival. The following surgical resection provided a R0 resection, leaving no macroscopic residual tumor. This result indicates a potential strategy for patients affected by unresectable cardia cancer. Clearly this strategy requires further analysis to be confirmed. However, based on our case report, the conversion surgery seems safe and feasible, associated with R0 resection. Disclosure All authors have declared no conflicts of interest.

Long-Term Survival in a Patient With Abdominal Sarcomatosis From Uterine Leiomyosarcoma: Role of Repeated Laparoscopic Surgery in Treatment and Follow-Up

2016 ◽  
Vol 23 (6) ◽  
pp. 1003-1008 ◽  
Author(s):  
Antonio Macciò ◽  
Paraskevas Kotsonis ◽  
Giacomo Chiappe ◽  
Luca Melis ◽  
Fausto Zamboni ◽  
...  
Keyword(s):  
Laparoscopic Surgery ◽  
Uterine Leiomyosarcoma ◽  
Term Survival ◽  
Long Term Survival

scholarly journals Post-surgical depressive symptoms and long-term survival in non-metastatic breast cancer patients at 11-year follow-up

2017 ◽  
Vol 44 ◽  
pp. 16-21 ◽  
Author(s):  
Michael H. Antoni ◽  
Jamie M. Jacobs ◽  
Laura C. Bouchard ◽  
Suzanne C. Lechner ◽  
Devika R. Jutagir ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Metastatic Breast Cancer ◽  
Depressive Symptoms ◽  
Cancer Patients ◽  
Metastatic Breast ◽  
Breast Cancer Patients ◽  
Term Survival ◽  
Long Term Survival

scholarly journals Reconstruction of the Aortic Arch in Newborns and Infants Using an Extended End-to-End Anastomosis

2021 ◽  
pp. 63-68
Author(s):  
Iaroslav P. Truba ◽  
Ivan V. Dziuryi ◽  
Roman I. Sekelyk ◽  
Oleksandr S. Golovenko
Keyword(s):  
Hospital Mortality ◽  
Aortic Arch ◽  
Median Sternotomy ◽  
Term Survival ◽  
Long Term Survival ◽  
The Mean ◽  
End To End ◽  
Aortic Arch Hypoplasia

The problem of the effectiveness of obstruction at the level of the aortic arch is still a matter of discus-sion in the modern literature. Traditionally, by excision of the coarctation part, in the presence of hypoplasia, the incision is extended to a narrowed area and a modification of the classical end-to-end anastomosis is applied in the form of an elongated or expanded variant. Recently, when proximal part is involved in the pathological process, cardiac surgeons have been more likely to use median sternotomy using other types of plastic surgery, including dilation of the narrowed area with a pericardial patch, or pulmonary artery tissue. Accordingly, the analysis of the results of the use of end-to-end anastomosis in young children with aortic arch hypoplasia, especially in view of long-term survival and the level of reoperation, is an important issue of neonatal cardiac surgery. The aim. To evaluate the effectiveness of the use of an extended end-to-end anastomosis after reconstruction of the aortic arch in children under 1 year of age. Materials and methods. The study material included 348 infants who underwent surgical correction of aortic arch hypoplasia through the method of extended end-to-end anastomosis from 2010 to 2020. The operations were performed at the National Amosov Institute of Cardiovascular Surgery of the NAMS of Ukraine and the Ukrainian Children’s Cardiac Center. The study group included only patients with two-ventricular physiology. There were 233 male patients (67%) and 115 female patients (33%). The mean age was 1.07 (0.20; 2.30) months, the mean weight was 3.89 (3.30; 4.90) kg, the mean body surface area was 0.23 (0.20; 0.28) m2. Diagnosis of aortic arch hypoplasia was based on two-dimensional echocardiography. Results. According to echocardiography, after surgery there was a significant decrease in the pressure gradient in the aortic arch from 48.3 ± 20.3 to 16 ± 6.9 (p<0.05), left ventricular PV increased significantly from 61.6 ± 12% to 66.3 ± 6.4% (p> 0.05). The hospital mortality was 1.7% (n = 6). The causes of mortality were not related to the end-to-end aortic arch technique. The duration of follow-up period ranged from 1 month to 9.3 years. Two deaths occurred in the follow-up period. Thirty-two (9.1%) patients developed aortic arch restenosis in the postoperative period. Balloon dilatation of restenosis was performed in 21 patients. Eleven patients underwent repeated aortic arch repair surgery through the median sternotomy. There were no central nervous system complications in the follow-up period. Conclusions. The use of an extended end-to-end anastomosis in the surgical treatment of aortic arch hypoplasia demon strates low hospital mortality and high long-term survival. Indications for the effective use of this type of reconstruction are hypoplasia of the isthmus and distal aortic arch.

scholarly journals Cardiac Metastasis from Medullary Thyroid Cancers with Long-Term Survival under Vandetanib

2021 ◽  
pp. 1-6
Author(s):  
Camille Buffet ◽  
Sophie Leboulleux ◽  
Françoise Kraeber-Bodéré ◽  
Caroline Bodet-Milin ◽  
Laure Cabanes ◽  
...  
Keyword(s):  
Kinase Inhibitor ◽  
Surgical Excision ◽  
Cardiac Metastasis ◽  
Term Survival ◽  
Long Term Survival ◽  
Thyroid Cancers ◽  
Medullary Thyroid ◽  
Cardiac Metastases

<b><i>Background:</i></b> Cardiac metastases from thyroid cancers are uncommon with a poor prognosis. There is a lack of long-term follow-up studies. <b><i>Cases:</i></b> We report 2 cases of cardiac metastasis from medullary thyroid cancer (MTC). Both patients presented limited metastatic disease apart from a cardiac metastasis. The initial diagnosis was challenging and was facilitated by functional imaging with an immuno-PET-CT using an anti-CEA bispecific antibody and a <sup>68</sup>Ga-labeled peptide. Both patients were treated with the multitarget kinase inhibitor vandetanib with prolonged stability. The first patient was alive at the last follow-up, 14 years after the diagnosis of cardiac metastasis. The second patient required surgical excision of the cardiac mass because of disease progression under vandetanib. <b><i>Conclusion:</i></b> These cases illustrate long-term survival and effectiveness of clinical management of 2 patients who developed cardiac metastases from MTC, in the current era of personalized medicine with targeted therapy.

Long-term survival and phenotypic spectrum in heterotaxy syndrome: A 25-year follow-up experience

2018 ◽  
Vol 268 ◽  
pp. 100-105 ◽  
Author(s):  
Anwar Baban ◽  
Nicoletta Cantarutti ◽  
Rachele Adorisio ◽  
Roberta Lombardi ◽  
Giulio Calcagni ◽  
...  
Keyword(s):  
Heterotaxy Syndrome ◽  
Term Survival ◽  
Long Term Survival ◽  
Phenotypic Spectrum

Prognostic selection and long-term survival analysis to assess overdiagnosis risk in lung cancer screening randomized trials

2020 ◽  
pp. 096914132092303
Author(s):  
Eugenio Paci ◽  
Donella Puliti ◽  
Francesca Maria Carozzi ◽  
Laura Carrozzi ◽  
Fabio Falaschi ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Cancer Screening ◽  
Survival Rates ◽  
Lung Cancer Screening ◽  
Term Survival ◽  
Long Term Survival ◽  
And Control ◽  
Screening Trial

Objectives Overdiagnosis in low-dose computed tomography randomized screening trials varies from 0 to 67%. The National Lung Screening Trial (extended follow-up) and ITALUNG (Italian Lung Cancer Screening Trial) have reported cumulative incidence estimates at long-term follow-up showing low or no overdiagnosis. The Danish Lung Cancer Screening Trial attributed the high overdiagnosis estimate to a likely selection for risk of the active arm. Here, we applied a method already used in benefit and overdiagnosis assessments to compute the long-term survival rates in the ITALUNG arms in order to confirm incidence-excess method assessment. Methods Subjects in the active arm were invited for four screening rounds, while controls were in usual care. Follow-up was extended to 11.3 years. Kaplan-Meyer 5- and 10-year survivals of “resected and early” (stage I or II and resected) and “unresected or late” (stage III or IV or not resected or unclassified) lung cancer cases were compared between arms. Results The updated ITALUNG control arm cumulative incidence rate was lower than in the active arm, but this was not statistically significant (RR: 0.89; 95% CI: 0.67–1.18). A compensatory drop of late cases was observed after baseline screening. The proportion of “resected and early” cases was 38% and 19%, in the active and control arms, respectively. The 10-year survival rates were 64% and 60% in the active and control arms, respectively ( p = 0.689). The five-year survival rates for “unresected or late” cases were 10% and 7% in the active and control arms, respectively ( p = 0.679). Conclusions This long-term survival analysis, by prognostic categories, concluded against the long-term risk of overdiagnosis and contributed to revealing how screening works.

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